Permits - Permit# 98-09 - 2429 Black Lake Road - 1/1/1998CITY OF SPRING PARK
BUILDING PERMIT APPLICATION
CITY OF SPRING PARK
P. 0. BOX 452
SPRING PARK, MN 55384-0452
Building Permit Application Requirments:
1. Application to be filled out & siggned
2. Mechanical Permit Application & Calculation filled out
3. Energy Calculations filled out
4. Furnish a Certificate of Survey - See Attached
5. Furnish 3 Sets of Construction Plans
a. 1 set for City Files
b. 1 set for builder to use on site
c. 1 set for city Building Inspector
Construction Plans should include:
1. First floor plan
2. Footing & foundation plan
3. Elevations of all sides
4. Wall sections & cross sections
5. Details - stairs & any special connections
Date Received:
Date Approved: '11L q'K
Permit No.: 1��09
Fees To Be Charged:
Permit $
State Surcharge :V,
Plan Review
SAC Charge
Availability Chrg
TOTAL $
ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED
THE APPLICANT IS: (Circle One) OWNER or CONTRA
JOB SITE ADDRESS rid 11 .KI C• C k Lc.k
NAME OF OWNER �► �I "' �'`G HOME PHONE
9-9 as
/ 9 - /i� -.--
.,2
WORK PHONE
MAILING ADDRESS LE a-"l
81 L .
K, Ok CITY
ZIP-S�53eg—
CONTRACTOR IN LkUTVS
S- 004
PHONE.Sg-1"0309'
MOBILE PHONE
MAILING ADDRESS CITY ti Vr►u �H. /� A/ ZIP SfI
STATE LICENSE NO. a,eo ( -.D -7
ARCHITECT/ENGINEER
MAILING ADDRESS
NAME
TYPE OF WORK: New Addition
Remodel/Alteration _
PHONE
�d�
REGISTRATION NO
Accessory Structure Move
Renovate Land Alteration _
PROPOSED WORK (Describe in Detail) �eur o':' 4 Re rooms Ao-lfe
ZONING DISTRICT
STORIES
W9
Demo
SQ. FEET OR EACH FLOOR NO. OF BEDROOMS GARAGE
STALLS ATT. OR DET. L" W
ESTIMATED CONSTRUCTION VALUATION (excluding land) $ 39 3 0 ° 0 0
HT
• CI FX OF SPRING PARK
BUILDING PERMIT APPLICATION
PAGE 2
HARDCOVER CALCULATION WORKSHEET
A. House X -
Length Width
X —
B. Garage X
C. Driveway X
X
D. Sidewalk X
X
E. PatiC/ X
F. Other X
X
1. TOTAL HARDCOVER
2. TOTAL PROPERTY AREA
1 -2
X 100 =
S.F.
S.F.
S. F.
S. F.
S. F.
S.F.
S.F.
S.F.
S.F.
S.F.
S.F.
S.F.
o�
I hereby apply for a building permit and I acknowledge that th information above is complete and accurate; that the work
will be in conformance with the ordi antes and codes of City and with the State Building Code; that I understand this is
not a permit and work is not to sta wi out a perm' ; nd that the work will be in accordance with the approved plan.
APPLICANT'S SIGNATURE DATE 4' I b " g i
INSPECTION REQUIRED:
Footing before a pour
Framing rough -in
Insulation
Wallboard before Taping
FINAL before occupancy
WORK BEYOND OR WITHOUT A REQUIRED
INSPECTION WILL BE SUBJECT TO PENALTY.
24 HOUR NOTICE REQUIRED
473-7357
WORK REQUIRING SEPERATE PERMITS
Plumbing
Mechanical
Well
Grading & filling
Sewer
Water
Electrical from State
ZONING CERTIFICATION
I do hereby certify to the Orono Building Official that the following described work has been reviewed for compliance with
the Zoning Requirements of the City of Spring Park and will be approved for construction upon approval of the
construction plans by the Building Official.
Name Date
BUILDING CODE PLAN REVIEW
Name
Date
r-orm No. cna—)ttev. ti-w-no)
wit
e
1 87.25
... ............................
Total
*0
$89.25
miner-uavis uu.,
atate of Minnroata, ....... J. y................. of..SPr.in9... park .....................................
County of ............ Hennep.in............... Office of Bu i .. d.. ng Inspector ---------............------...
i�Permit
g
IN CONSIDERATION OF The statements and representations made by...........................................................................
Western Cedar Supply
------------------------------------------------------•---...---................------------------...........-----.........--------................-.....................
in.A 1 S_.__._._.___application therefor duly filed in this office, which application is hereby made a part hereof, PERMISSION IS HEREBY
GRANTEDTo said. Western ...Cedar ...SuP..PI.Y.............................................._........................................................ as owner
Tear off and re-r f .p. ��. a building described as follows: kind of construction
to QQ hQ.t�se er.... a 1.i ca.t.i-are ..............
(build, erect, install, add to, alter, repair, move, wreck, as the case may be)
front or width in feet ................
number of stories -----------------------
......---•--------------; side or length in feet ...................................................... ; height in feet ------------------------------------------------------ ;
; contents..................................................................cubic feet; ............... .................................... square feet, upon that
tract of land described as follows: Lot ....... ..................................... Block ........................................................... ; plat or addition .........................................................
2429 Black Lake Road 19-117-23-12-0018
..................................................................................................................................................................................................................................-----...----------.....-----..........................-----.......--•---
which tract is of the size and area specified in said application.
This permit is granted upon the express conditions that said owner and h_i_S_ contractors, agents, workers and employees, shall
comply in all respects with the ordinances of the .............. �1.tY................................................... of..........P.rilr.l9... Part .................................... ; that it does
not cover the use of public property, such as streets, sidewalks, alleys, etc., for which special permits must be secured; and that it does
not cover the following: ...... None of the following ......................... . ...-•-•--......g........ - ......................
(Electrical work, plumbing, heating, plastering, etc., if such there be.)
for which special permits must be secured.
Given under the hand of the ........ B-0-.1.ding... .Inspector ......................of said..........City
and its corporate seal and
attestedby its ....................... .leek................. -----------•------......this ........ !-6th............................day of ........... AA.r l.....---...---.........-------------•-••-•-----------.................19-DB-------
Attest:
PatriciaHi - us.................. .............................. LY.le....Oman--•--•------:-•- ....-----J
.............................
Clerk Building Inspector
..............